Zanette G, Righetti C, Manganotti P, Polo A, Tinazzi M, Fiaschi A, Tosi L
Institute of Neurology, University School of Medicine, Verona, Italy.
Eur Neurol. 1995;35(2):93-8. doi: 10.1159/000117100.
We examined the characteristics of specific components of the evoked electrospinogram (EESG) in response to tibial nerve stimulation in 28 patients with traumatic injury of the dorsal and cervical spinal cord. The data were correlated with clinical, urodynamic and additional neurophysiological findings. In the majority of patients (82%), 11 with complete and 12 with partial spinal cord lesions, the lumbar components of the EESG were normal. In 4 of these patients with complete lesion above T2 the dorsal EESG was absent. In 5 cases (18%), the lumbosacral EESG was altered in the presence of an atypical clinical syndrome characterized by persistent urinary retention associated with lower leg atrophy and reduced tendon jerks. In these cases, MRI provided evidence of an unexpected sacral lesion. Unlike the dorsal EESG reflecting the afferent dorsal column volley, the lumbar components of the EESG are usually unaffected by interruption of the cord pathways; these last events thus originate from segmental neuronal activity, the involvement of which bears witness to additional lumbosacral damage.
我们研究了28例胸段和颈段脊髓创伤性损伤患者在胫神经刺激时诱发的电脊髓图（EESG）特定成分的特征。将这些数据与临床、尿动力学及其他神经生理学检查结果进行关联分析。大多数患者（82%），其中11例为脊髓完全损伤，12例为部分损伤，其EESG的腰部成分正常。在其中4例T2以上完全损伤的患者中，背侧EESG缺失。5例患者（18%）存在以持续性尿潴留伴小腿萎缩和腱反射减弱为特征的非典型临床综合征，其腰骶部EESG发生改变。在这些病例中，MRI显示存在意外的骶部病变。与反映传入背柱冲动的背侧EESG不同，EESG的腰部成分通常不受脊髓通路中断的影响；因此，这些最后的事件源于节段性神经元活动，其受累表明存在额外的腰骶部损伤。
